A case report of an anorexia nervosa patient with end-stage renal disease due to pseudo Bartter's syndrome and Chinese herb nephropathy requiring maintenance hemodialysis.
The extent of end stage renal disease (ESRD) has not been well documented in anorexia nervosa (AN). We herein describe a 47-year-old female with ESRD who required maintenance hemodialysis (HD) following a 27 year history of AN, and seven years of diuretic and purgative abuse. In spite of HD treatment, her serum inorganic phosphorus level remained elevated (10.2-15.8 mg/dL). Tissue degradation due to catabolism, insufficient dialysis treatment, and use of Chinese herbal medicine, including aristolochic acid, are speculated as the cause of her hyperphosphatemia. We also speculated that the causes of her renal dysfunction are as follows: chronic interstitial nephritis caused by pseudo Bartter's syndrome resulting from chronic abuse of diuretics and purgatives, and Chinese herb nephropathy.
Wada
Kentaro
K
Department of Internal Medicine, Division of Nephrology and Dialysis, Nippon Kokan Fukuyama Hospital, Daimon-cho, Fukuyama, Hiroshima, Japan. kyw620@hotmail.co.jp
Shinoda
Toshio
T
D000856:Anorexia Nervosa / Q000150:complications* / Q000175:diagnosis; D001477:Bartter Syndrome / Q000150:complications*; D001774:Blood Chemical Analysis; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D007677:Kidney Function Tests; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016482:Urinalysis
D004365:Drugs, Chinese Herbal